Blue Crossed
Monday August 17th 2009, 6:59 pm
Filed under: Family,Politics

Pardon another rant. I do try to keep them to a minimum. Ooh, looky, the baby alpaca stole is done! (Did that help?) Bluejay shawl pattern, three repeats plus an extra stitch each side, cast on 36.

We were sure it was coming. But still.

Remember my saying insurance companies look back through your records up to 20 years to look for something to deny you coverage over?

Our daughter aged out of ours and we’ve got her on COBRA while we can, at nearly four times the rate of private health insurance.  Same company, same coverage.

They denied her attempt to get her own policy, in part because she had a) a cataract sixteen years ago as a young child (which she fully disclosed) and because b) she had the surgery for it.

Wait–what?!

The note from the insurance agent said to try again if we keep up the COBRA the full 18 months it’s good for: by that point, the insurance might be required to take her on.

Might.  If.  If.  If healthcare reform happens. If it does, my normal, young, healthy daughter will be able to pay premiums and help support the system. If it does not, COBRA will end, we can’t cover her even with an inflated price, and she will have no coverage.  Should anything major happen to her that would keep her from working, she will have no choice but to be a burden on the taxpayers even though that’s the last thing she wants to do.

Note that our premiums didn’t go down in the slightest with three kids aged out.


27 Comments so far
Leave a comment

Grrrr…. You know I’m with you 100% on this one. It makes me sick to think about it (get it? get it?). Sigh…

I love the stole, though!

Comment by Jocelyn 08.17.09 @ 7:44 pm

Medical insurance never ceases to amaze me.

In New Zealand, where I live, we have (GST)Goods and Services Tax levied on everything, it is across the board, that includes medical fees and basic foodstuffs, currently it is 12.5%, but there is a Review Committee that is recommending it be raised to 15%. I wonder about the morals of ill patients being taxed on seeing a doctor. The mind just boggles.

Comment by StellaMM 08.17.09 @ 7:53 pm

Boy! Am I ever with you on the health care reform! It seems to me that the insurance company is working against itself — they could be covering a healthy young lady, which is the kind of clientele I thought they wanted.

Oh, well, let’s try to get out of bad humor with (ahem) good humor:

More Seen in Newspapers:

Now is your chance to have your ears pierced and get an extra pair to take home too.

We do not tear your clothing with machinery. We do it carefully by hand.

For sale. Three canaries of undermined sex.

Great Dames for sale. Have several very old dresses from grandmother in beautiful condition.

Tired of cleaning yourself. Let me do it.

Vacation Special: have your home exterminated.

Mt. Kilimanjaro, the breathtaking backdrop for the Serena Lodge. Swim in the lovely pool while you drink it all in. The hotel has bowling alleys, tennis courts, comfortable beds, and other athletic facilities.

Get rid of aunts. Zap does the job in 24 hours.

Toaster: a gift that every member of the family appreciates. Automatically burns toast.

For Rent: 6-room hated apartment. Man, honest. Will take anything.

Comment by Don Meyer 08.17.09 @ 8:46 pm

Insurance companies have always been grifters. Way back in 1965, we were not able to add our baby boy to our health insurance and/or our life insurance because of complications when he was born and during his first year. Due to him being refused coverage then, we were never able to get insurance for him, even when he was healthy. Then when he became totally disabled, he was on Medicaid so was able to have his medical needs met, thanks to the taxpayers of this country. I was, finally, able to get a burial policy on him a couple years before he died but that is all. I hate insurance companies.I hope this will turn out better for your daughter.

Comment by sherry in idaho 08.17.09 @ 9:03 pm

I forgot to mention how lovely the shawl is, due to going off on my rant. Sorry about that!

Comment by sherry in idaho 08.17.09 @ 9:04 pm

Absolutely lovely shawl, lucky recipient!
As for the denial of insurance due to the reasons stated is wrong and definitely unconscionable!
However, most likely the reason your premium did not go down once your children aged out is that you were on a family plan where it did not matter how many children you had covered. At least that is the way with our insurance, only my husband and I are covered and we pay the same premium as couples with one or 5 or more children!

Comment by Ingrid 08.17.09 @ 9:49 pm

That was a calm statement of fact. You are entitled to be much rantier on this. Scandalous.

Comment by LynnM 08.17.09 @ 11:33 pm

Oh, Alison, that is absolutely awful. Everyone who is unsure or against what the proposed health care reform will offer should read http://www.trailingyarn.com/archives/2875

Comment by Joansie 08.18.09 @ 5:01 am

Lovely (as usual) scarf. Sad, frustrating story about the insurance. I’m not one to wish bad things on people (I think it damages the wisher more than the person to whom it’s directed) but one thing I do wish is that people who treat others that way come around at some point to realize how awful they’ve been, and change their ways.

Comment by (formerly) no-blog-rachel 08.18.09 @ 5:18 am

Your scarf made me smile. I see softness to hold after blows of life, coolness under pressure and love that keeps you going. Is that part of the material needed to knit such a lovely project?

I am sorry to read about the cul-de-sac your family is in regarding health insurance.I suppose there are somethings that cannot make sense, no matter how you turn it around…

I know some people (Americans) who are dead against your health care reform, even more so when they see how long waiting times can be, here in Canada, to see a doctor or get an appointment… Still, I am quite happy to have it, being a freelancer. I have no idea how expensive such an insurance would be for me otherwise and I might not be able to afford it. Then what? With all the rules and exceptions, mainly the exceptions, how are you suppose to hope to be covered?

I agree with your friend Don: your daughter should be the perfect customer for them. Don’t the companies WANT to have insurance holders?

Boggles the mind…

Speaking of health, how is yours coming along? Are you being a good patient? 😉

Comment by Suzanne in Mtl 08.18.09 @ 5:48 am

WHAT?! That’s insane. Truly.

Comment by Channon 08.18.09 @ 6:32 am

I got a taste of dealing with a private insurance company recently, one that I had paid into over the course of my nursing career. I could no longer work, was at the lowest of my lows, and they had me jumping through so many hoops I finally gave up on my claim. I just didn’t have the ooomph to fight it any more. It was our (Canadian) federal government plan that came through for me in the end. I feel your frustration and hope that Obama can find a solution to the U.S. health care woes. Our health care isn’t the best (it is very overburdened and heavy on ‘management’, short on manning the front lines) but for the most part it works without having to argue with anyone as to whether or not you will have coverage.
I’m so glad you’re on the mend, Alison. Knit on!

Comment by Julie 08.18.09 @ 7:30 am

My school insurance ran out (yesterday, in fact), and I’m anxiously awaiting to hear whether a private company will take me. It’s likely to give me an ulcer–which then, of course, will be a pre-existing condition.

Comment by Lanafactrix 08.18.09 @ 9:37 am

I feel your pain Allison. With lupus, it’s always very, very scary every time I change jobs. Will I get hit with a pre-existing clause, will I be denied coverage? I’ve got a friend in England with brittle asthma (very severe). She told me a few years ago that she doesn’t understand how Americans can do it. She’d have had to file for bankruptcy years and years ago, if not for socialized medicine. She was in her early 20s at the time.

Comment by Serena 08.18.09 @ 10:28 am

These are disturbing times. I hope the healthy folk who are making decisions find some sort of insight into the world in which people with health challenges live.

Comment by Diana Troldahl 08.18.09 @ 10:49 am

I forgot to mention how well the shawl turned out :-}
The artistic blue jay story is one of my favorites!

Comment by Diana Troldahl 08.18.09 @ 10:51 am

What’s there to say – we need health care insurance reform. Note I did not say “health care reform” because our health care isn’t bad, but our health care insurance is criminal.

Comment by Leslie 08.18.09 @ 11:02 am

Have you tried Blue Cross Blue Shield? Does California have a “plan of last resort”? Also, some insurance companies will cover a person for “everything but” the pre-existing condition.

Comment by Karen Lewis 08.18.09 @ 2:48 pm

I forgot to say: as long as the insured has been in a group health plan, and there’s not a break in coverage of more than 63 days (including COBRA!) then no pre-existing condition clause is allowed to be applied to the new insured. That’s HIPAA law.
Also, now that its 2009, if you have a baby, no matter the baby’s health situation and the parent is covered under a group health plan, the baby can be added IF it is done within the first (um…30?) days.
*Some* plans have wised up on premiums and there’s a premium for Employee + 1 and then Family. The ee+1 could be single parent with single child. *some*
Enlightenment has been slow in coming. A few companies have plans that exclude coverage for pre-existing conditions for up to 2 years and then will cover anything.
What everyone forgets is that the price of medicine these days is *high* because we are habitually buying miracles with our dollars. 60 years ago, strep throat could kill you. 40 years ago, there was no such thing as “coronary bypass” surgery. 15 years ago, there were no practical anti-virals.
And folks like Alison never would have made it through to get to where she is now, enriching everyone’s lives with her generosity of spirit.
We buy miracles every day, and no surprise, they cost money.

Comment by Karen Lewis 08.18.09 @ 3:03 pm

Your first paragraph above: if that were true, she couldn’t have been denied. But she was. Note that she applied within the month of her birthday.

Laws covering HMOs vs. private insurers are different: private ones can use anything whatsoever as a pre-existing condition, even if it has no bearing whatsoever on the current condition. It is not insurance: it is a Ponzi scheme for insurance company executives.

Comment by AlisonH 08.18.09 @ 3:56 pm

Beautiful scarf! Good rant but far too mild, IMHO. And your final comment? On the button!

Love & Hugs,
Gretchen

Comment by Gretchen 08.18.09 @ 6:28 pm

Rant away! The system is messed up. Period.

Comment by Momo Fali 08.18.09 @ 7:30 pm

You are so right. And a well reasoned rant it is. 🙂
Lovely scarf, of course.

I went last Saturday to Congressman Pete Stark’s town hall meeting here in Fremont on the health care reform plan. I didn’t actually get in due to the many hundreds of people who showed up, but it was quite an education just going around the crowd with my camera and listening to lots of people’s stories.

The anti-health care people were out in force, and they were quite vocal and many were quite rude. And though I went through that crowd several times, I did not see a single person who professed to be against the health care plan in a wheelchair, or on a walker, or in any visible way disabled. Whereas there were a lot of people with health issues there in support of the health plan. And honestly, the people in support of health care reform were generally quiet and polite. Which may be part of the problem; the loudmouths are getting a lot of press and getting heard, even though many of their messages are angry and confused and illogical. It all made me sad and frustrated. I got a lot of pictures of people from both sides and I’ll do a write-up of it for a few organizations, but I’m losing heart that the plan will have any chance of passing. Things must change. I just can’t comprehend how so many of these angry people can’t see that.

Anyway. Didn’t mean to derail your blog! Hope the recovery is going well and still sending out healing thoughts for you. 🙂

Comment by Beckett 08.18.09 @ 10:26 pm

Over the past few years, I’ve taken several trips from here in Alison’s home town to California. I typically leave home around 5 a.m. where a patient cab driver is waiting for me in front of the house. I love to hear about their lives; they are usually willing to tell me about them. One thing I hear is: no health insurance.

It inevitably causes me to wonder. It doesn’t make sense to me for apparently responsible, hard-working people to be left hoping they don’t get sick. Because they will get sick. And it seems to me that it might be at a higher cost to all of us than it otherwise might be.

Comment by RobinM 08.19.09 @ 4:54 am

So if she didn’t have the surgery, she would have been covered? Whut? This is insane….

Comment by Carol 08.19.09 @ 6:45 pm

Can I just tell you how much I resent this current “system”?

Comment by karin maag-tanchak 08.20.09 @ 8:36 am

Bypass the insurance front lines. Call the Calif. Insurance Commissioner’s Consumer Hotline.
1-800-927-HELP (4357) or 213-897-8921

You can fill out the complaint form later.
http://www.insurance.ca.gov/contact-us/0200-file-complaint/

Comment by Betsy 08.31.09 @ 10:29 am



Leave a comment
Line and paragraph breaks automatic, e-mail address never displayed, HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

(required)

(required)